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Can drugs suppress suicidal ideation in children with ADHD?

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A longitudinal cohort study found that drugs used to treat attention deficit / hyperactivity disorder (ADHD) were associated with a reduced suicide rate in children who externalized the symptoms of the condition. ..

ADHD drug use was associated with reduced suicide behavior in children aged 9 to 11 years with more severe externalized symptoms such as hyperactivity, oppositional defiantness, and other symptoms of conduct disorder (significant). Symptomatology and drug interaction B = -0.250, SE = 0.086 P = 0.004), reported by Ran Barzilay, MD, PhD, and colleagues at the Philadelphia Children’s Hospital.

Not only that, there was a significant association between symptom externalization and suicide rate in children not treated for ADHD (symptom 1 SD change, OR 1.42, 95% CI 1.33-1.52). , P <0.001), the author JAMA network open..

However, for children taking this drug for symptoms, there was no significant association between symptoms and suicide rate (OR 1.15, 95% CI 0.97-1.35, P = 0.10), they added.

In the analysis of Adolescent Brain Cognitive Development (ABCD) Studies Based on the data, researchers conducted a one-year follow-up analysis to determine how ADHD treatment affected the association between baseline externalization of children and reporting of suicidal tendencies.

The average age of participants was about 10 years, with 52.2% being boys. About three-quarters of children were white. Drugs for ADHD included methylphenidate (Ritalin) and amphetamine derivatives, an α-2 agonist, and atomoxetine (Stratera).

At baseline, it contained 11,878 children. Of these, 1,060 were treated for ADHD and 1,040 reported past or present suicidal ideation or emotions. More boys reported suicidal behavior than girls (58.0% and 42.0%, respectively), but there was no difference in suicidal reports among children of different race / ethnic backgrounds.

Adjusted analysis found both ADHD treatments (OR 1.32, 95% CI 1.06-1.64, P= 0.01) and externalization of symptoms (OR 1.34, 95% CI 1.26-1.42, P<0.001) was associated with suicidal tendencies.

In line with previous trends, the study found that at 1 year of age, children with strong extrinsic symptoms who were on ADHD at baseline were less likely to report suicidal behavior ( Significant symptomatology-drug interaction B = -0.34, SE = 0.18, one-sided test P = 0.03).

And for children who did not take medication at baseline, the authors found an association between higher externalized symptoms and a higher probability of reporting suicidal feelings (OR 1.33, 95% CI 1.14-1.55). , P <0.001). Investigators say these links were observed in both boys and girls alike.

“Our findings address a significant childhood suicide knowledge gap,” wrote Bargeley and colleagues, who have seen a rapid increase in childhood suicide cases over the last decade. “The results provide simple and viable goals for optimizing prevention plans and intervention strategies for elementary school children with externalization problems.”

According to them, the significant limitations of this study cannot explain the number of high-risk children who may have received other forms of mental health treatment or intervention that may have influenced the outcome. That’s what it means.

Researchers suggest that future analysis of ABCD study data should be conducted to better understand adolescent suicidal ideation rates, which increase the rate of suicidal ideation.

  • Author['full_name']

    Kara Grant In February 2021, he joined MedPage Today’s Enterprise & Investigative Reporting team. She is in charge of psychiatry, mental health and medical education. follow us

Disclosure

The study was supported by grants from the National Institute of Mental Health, the Philadelphia Children’s Hospital Lifelong Brain Institute, and the University of Pennsylvania Pennsylvania Institute.

Barzilay has revealed a financial relationship with Taliaz Health, the mental health platform for artificial intelligence.



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